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Biomedical subjects

F B Kristensen

Publications and source records attributed to F B Kristensen.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Preventive check-ups of pregnant women in Denmark. Common ailments in pregnancy].

The study was conducted in order to describe the extent and content of advice on common ailments in pregnancy given by doctor or midwife during prenatal visits and to describe the frequency of ailments in the period before the visits. The design was a nationwide cross-sectional study based on questionnaires completed by pregnant women who had seen a general practitioner (GP), midwife or hospital doctor for prenatal care. Ailments and advice in connection with one specific visit were reported. The questionnaires were completed by 517 women after a prenatal visit to their GP (92% of eligible), by 514 women after a prenatal visit to the midwife (91% of eligible), and by 203 women after a prenatal visit to a doctor in the maternity department in pregnancy week 16-18 (84% of eligible). The results showed that nausea, pollakisuria, tiredness and heartburn had been present during the period before the visit in about half the women. Between a third and a fourth of the women had been discomforted by back pain, discharge or cramps. From 15 to 58 percent had been given advice, depending on the symptom. The advice was of many different kinds. To a large extent the women wanted to talk to the health professionals about the ailments, and most often they wanted to talk to a midwife about the ailments. We conclude that common ailments of pregnancy are frequent and they should be investigated more. Nearly all pregnant women want to talk about the subject during prenatal visits. The objectives of giving advice should be clearer, and clinical studies of the effectiveness of the advice are needed.

Cross-Sectional Studies↗
PubMed1993

[Preventive health examinations of pregnant women in Denmark. Anamnestic practice and discussion of prenatal diagnosis in early pregnancy examinations in general practice, birth clinics and birthing centers].

In Denmark, pregnant women are offered antenatal care in a nationwide programme. This programme is organized around health examinations in general practice, hospital outpatient departments and at midwives' centres. During winter 1986-1987, a nationwide investigation of antenatal care was carried out. A random sample of approximately 1/3 of the general practitioners, all of the midwives who had antenatal consultations and the medical staffs of 26 departments of obstetrics and gynaecology received a questionnaire about content of a definite antenatal examination. 62% of the general practitioners, 63% of the doctors at the place of delivery and 86% of the midwives replied. Among the pregnant women, 92% replied from general practice, 84% from hospital outpatient departments and 91% from midwives' centres. The interviews about date of delivery and genetic counselling at early visits in general practice, hospital outpatient departments and at midwives' centres were in agreement with the nationwide guidelines. Employment of routine ultrasound scanning was not associated with less detailed history taking by the doctors at hospital outpatient departments, where ultrasound scanning was employed only on special indications. It was concluded that there was a considerable overlap between the interview about the date of delivery and genetic counselling at early visits in general practice and in hospital outpatient departments and, to some extent, at the midwives' centres. The sharing of responsibility for care of pregnant women by three professional groups requires specification of the content of the consultation. Official guidelines should be more specific about this point.

Birthing Centers↗
PubMed1993

A comparison of prenatal care use in the United States and Europe.

OBJECTIVES: We sought to describe prenatal care use in the United States and in three European countries where accessibility to prenatal care has been reported to be better than it is in the United States. METHODS: We analyzed the 1980 US National Natality Survey, the 1981 French National Natality Survey, a 1979 sample of Danish births, and a survey performed from 1979 to 1980 in one Belgian province. RESULTS: The proportion of women who began prenatal care late (after 15 weeks) is highest in the United States (21.2%) and lowest in France (4.0%). This contrasts with the median number of visits, which is greater in the United States (11) than in Denmark (10) or in France (7). Across all maternal ages, parities, and educational levels, late initiation of prenatal care is more frequent in the United States, and median number of visits in the United States is equal to or higher than that in the other countries. CONCLUSIONS: In countries that offer nearly universal access to prenatal care, women begin care earlier during pregnancy and have fewer visits than women in the United States.

Adult↗
PubMed1993

Increased risk of preterm birth in women with cervical conization.

OBJECTIVE: To determine the relation between cervical conization and preterm birth. METHODS: All Danish women with singleton pregnancies who gave birth to their first infant in 1982 and second infant during the time period 1982-1987 were included in a register-based cohort study. Information on pregnancy outcome and cervical conization in 1977-1987 was obtained from the Medical Birth Register and the National Register of Hospital Discharges. RESULTS: In a cohort of 14,233 women, 170 had cervical conization. Thirty-four had cervical conization before the first delivery, 62 between the first and the second, and 74 after the second delivery. Women with cervical conization had a significantly higher risk of preterm birth. In addition, women with subsequent cervical conization had a higher risk of preterm birth in previous pregnancies. However, the risk of preterm birth was higher in women with previous than with subsequent cervical conization. CONCLUSIONS: Cervical conization is correlated with preterm birth. Because women with subsequent cervical conization have an increased risk of preterm birth in preceding pregnancies, factors other than the surgical intervention may contribute to the significantly increased risk of preterm birth.

Adult↗
PubMed1992

Antenatal care in Denmark. Assessments of program, staff competence, compliance, and outcome.

Antenatal care in Denmark is shared between general practitioners, midwives, and hospital departments. A minimum of 9 visits is officially recommended for all pregnant women. In 1987, 80% made 10 or more visits. An inadequate number of visits in relation to recommendations was most frequent in the lowest social group. Risk of stillbirth and neonatal death varied substantially between social groups even after taking account of number of visits made.

Denmark↗
PubMed1992

Life table analysis of infant mortality and feto-infant mortality distributed on causes of death in Denmark 1983-1987.

The survival function of 263,322 singletons of the 1983-1987 Danish birth cohorts (262,159 liveborn and 1163 stillborn babies) with mortality distributed on functional groups of underlying causes of death is presented in two graphic forms on the basis of Kaplan-Meier estimates. About half of all first-day deaths in liveborn babies occurred during the first 4 hours. More than half of all first-week deaths happened during the first day. More than half of all deaths from 31 weeks to 76 weeks after the first day of the last menstrual period (LMP) were either fetal deaths prior to the onset of labour unexplained by fetal factors or unexplained sudden infant death syndrome (SIDS) deaths. Graphic presentation of feto-infant mortality distributed on functional cause-of-death groups improved the expression of the relative contribution and timing of the different causes of deaths. Despite a high autopsy rate and a uniform coding practice the distribution on causes of deaths from register data should be interpreted with caution. Full use of the feto-infant approach is only achieved with data which include late abortions. Thus the feto-infant approach is of special interest in countries which have registers of live births and fetal deaths from week 22 of gestation or earlier. The integration of the life table approach and analysis of underlying causes of deaths should be further explored as a way of utilizing vital statistic databases for the evaluation of perinatal care.

Cause of Death↗
PubMed1992

Peer comparison feedback to achieve rational and economical drug therapy in general practice: a controlled intervention study.

The aim of the study was to describe and evaluate a controlled intervention to achieve more rational and economical drug therapy in general practice. The strategy was based on peer comparison feedback and encouragement of local peer group discussions. Seven districts comprising 53, and 6 districts comprising 55 eligible practices constituted the intervention and control groups respectively. The process was evaluated by questionnaires to the GPs. 88% found the feedback diagrams relevant, and 74% expressed a wish for information about prescribing of particular drugs. The outcome evaluation was based on computerized registration of prescriptions. During the study period of 6 months the median costs per prescription increased significantly in the control group, whereas there was no statistically significant change in the intervention group. There were no significant effects on the prescribed amounts.

Cost Control↗
PubMed1990

[The use of free maternal preventive services among immigrant pregnant women in Denmark during 1983-1987].

As part of an investigation of immigrants' living conditions in Denmark, we have investigated how pregnant immigrant women utilize the possibility of free examinations during pregnancy. The study is based on data on all deliveries in Denmark in the years 1983-1987, retrieved from the Danish Medical Birth Registry concerning parturient women with permanent address in Denmark and who were born in either one of the Scandinavian countries, Yugoslavia, Turkey, Pakistan, Marocco, Iran of Vietnam. The women born outside Scandinavia gave birth to about 6,500 infants during the study period; roughly half of these were borne by Turkish women. The largest percentage of young parturients were found among women from Turkey and Yugoslavia. Pakistani and Maroccan mothers had higher parity. These two groups were especially concentrated in the municipality of Copenhagen, where half of the parturient women lived. A few lived in the remainder of the country while a total of 85% lived in the metropolitan area. Four out of ten pregnant Turkish or Pakistani women had been examined by a midwife less than the five times recommended. Among those living in the metropolitan area. Danish women have an average total of almost 11 examinations compared to 8.2-8.9 among immigrants. The conclusion of the study is that the immigrant women have less contact with the free antenatal care system during their pregnancies than the Scandinavian women and that the differences are greatest when examinations by the midwife were concerned. Further discussion on antenatal care in Denmark, is required.

Adult↗
PubMed1990

[Variations in frequency of Cesarean sections in Denmark].

An investigation is presented on the basis of the medical register of births concerning all primiparae who were delivered of a liveborn singleton infant in 1982 and 1986. On the basis of the section on complications in the notification of the births, we have made a subdivision into four "approximate indications". We find a variation in frequencies of Caesarean section from 9.7% (1982) to 17.1% (1986) between the various counties and an increase during the period investigated of 19%. 50% of the increase occurred in the group termed "other causes", 25% in the group of foetal distress and 25% in the group of dystocia. The group of breech presentations is, by and large, unchanged in Denmark as a whole but great differences are present between counties. This register investigation does not permit the possibility of deeper analysis of the reasons for the variations.

Cesarean Section↗
PubMed1990

[Labor complications and interventions in immigrant and Danish women during the period 1983-1987].

Based on data retrieved from the Danish Medical Birth Register, deliveries among Danish and immigrant women were compared in the years 1983-1987. The women were divided into two groups, primiparous and multiparous, and then compared by frequency and type of complications and interventions during labour. Five hospitals in the Copenhagen area were selected and more than 40,000 women were included in the survey. About 3,500 were from Yugoslavia, Turkey, Pakistan and Morocco and the remainder were from Denmark. An increased frequency of complications and interventions during labour was recorded among primiparous in comparison to multiparous during the period. This observation was not related to nationality. Stimulation of labour by intravenous drugs was more frequent among immigrant women than Danish women and was particular frequent among Moroccan and Pakistani women. Among these nationalities higher frequencies of complications were not recorded and the use of intravenous drugs did not imply more instrumental deliveries. It is presumed that one of the reasons why the use of intravenous drugs is more frequent among immigrant women is due to a feeling of insecurity during labour. This might be caused by defective communication between the woman in labour and the midwife. The subject calls for closer investigations based on case records and the women's own experiences. The necessities for special training of immigrant women and staff members in maternity wards are pointed out.

Adult↗
PubMed1989

[Preventive health examinations of pregnant women in Denmark. Structure and organization].

In Denmark, pregnant women are offered antenatal care in a nationwide programme. This programme is organized around health examinations in general practice, midwives centres and hospital outpatient departments. During the winter 1986/87 a nationwide investigation of antenatal care was carried out in Denmark. A random sample of approximately 1/3 of the general practitioners, all of the midwives who had antenatal consultations and the medical staffs of 26 departments of obstetrics and gynaecology with more than 100 deliveries in 1985 received a questionnaire about the content of a definite antenatal examination and certain conditions of organization. The obstetricians could describe three different types of antenatal examinations depending upon the place and arrangement of work. The percentage replies received were 62 for general practice, 86 for the midwives and 62, 69 and 55 from the doctors in the place of delivery. 50% of the pregnant women had been attached to the same practice for at least five years. 70% of the general practitioners performed approximately one antenatal examination weekly. Only few hospital districts had attempted to have the first examination by the midwife at the 12th week of pregnancy. 25% of the places for examination by midwives were outside hospitals, which, according to the guidelines for antenatal care, do not entirely fulfill the intentions concerning situation in the patient's immediate surroundings. All of the obstetric departments offered routine examinations in the 16th-18th weeks and a number of these also routine examinations in the third trimester.(ABSTRACT TRUNCATED AT 250 WORDS)

Denmark↗
PubMed1989

[Preventive health examinations of pregnant women in Denmark. Education, supervision and postgraduate education].

A questionnaire about the content of a concrete antenatal examination and their own qualifications was sent to a random sample consisting of 1/3 of general practitioners in Denmark, all of the midwives who had antenatal consultations, the medical staffs of 26 departments of obstetrics and gynaecology and 26 surgical departments with more than 100 deliveries in 1985. The medical staffs could describe three different types of antenatal examinations depending upon the place and function. The percentages of replies received were 62 for general practice, 86 for midwives and 63, 69 and 55 for the medical staffs of the institutions involved. 49% of the general practitioners had worked in departments of obstetrics and gynaecology for at least six months. 62% of the doctors who described antenatal examination in week 16-18 were house officers or registrars and 28% were specialists. Among the medical staff who described an antenatal examination of a woman with an at risk pregnancy, 61% were consultants or senior registrars and 49% were specialists. The commonest goal for postgraduate training where non-specialists were concerned was general practice. Supervision in one form or another was possible in all of the departments participating, as a rule because an experienced colleague was present in the outpatient department. Supervision may be improved by alterations in the working arrangements.

Denmark↗